QUERI – Quality Enhancement Research Initiative

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Quality Improvement Methods

45. SMART (Specific, Measureable, Attainable, Relevant, and Time-Sensitive) Goals

a. Definition: To better assure a QI effort's effectiveness, it is important that the direction of a research project, or other efforts, should be directed properly. The attributes of so-called SMART Goals are that they are Specific, Measurable, Attainable, Relevant and Time-sensitive. The acronym makes clear the aspects that goals should have. Not incorporating these attributes means that an improvement effort will not achieve the desired effect. Specific goals should be simple and clearly defined. Measurable goals should provide tangible specific evidence from available data. Attainable goals should be achievable but demanding. Relevant goals should measure the outcomes relevant to the desired results. Time-sensitive goals identify when they are to be achieved although they often result in a tension between the urgency of getting results and the limitations in place. SMART goals incorporate all these aspects and must be written down and circulated to those affected by them.

b. Literature:

  • Meyer, Paul J. "What would you do if you knew you couldn't fail? Creating SMART Goals." Attitude Is Everything: If You Want to Succeed Above and Beyond. Meyer Resource Group, Incorporated (2003).
  • Doran, George T. "There's a SMART way to write management's goals and objectives." Management Review 70.11 (1981): 35-36.
  • Bovend'Eerdt, Thamar JH, Rachel E. Botell, and Derick T. Wade. "Writing SMART rehabilitation goals and achieving goal attainment scaling: a practical guide." Clinical rehabilitation 23.4 (2009): 352-361.

c. Example: A clinic decides to implement a new screening procedure. The organization wants to be sure the change is effective and decides to begin with SMART goals, which are; Specific - the new procedure is to be applied to all new and existing patients, Measurable - the goal will be to record use of the procedure in the clinic's electronic information system which will produce data on the number and percentage of patients screened, Attainable - they plan to have the procedure used for more than 95% of patients who visit each month, which is feasible, Relevant - the goals respond to expectations of the nursing department's leadership, Time-sensitive - the improvement must be fully implemented by the end of the year.

d. Steps:

1) Set goals while following the SMART attributes, write them down and circulate them to those affected.

2) Track the results against the goals with specific tasks to achieve them.

3) Report the results on a regular basis.

4) As changes take place, continue to focus on these goals and revise plans as necessary to assure achieving them.